A National Survey of Operating Theatre Experiences Among English Student Diagnostic Radiographers

Authors

DOI:

https://doi.org/10.7577/radopen.6446

Keywords:

Operating theatre imaging, C-arm imaging, student radiographers, education and training

Abstract

Introduction: Theatre radiography is an important part of a diagnostic radiographer’s scope of practice, supporting safe imaging during surgical procedures. However, studies indicate that newly qualified radiographers often lack confidence in theatre imaging, particularly using C-arms, and that post-qualification training in hospitals is frequently brief and not competency based. This survey aimed to evaluate pre-registration educational experiences in universities and clinical hospital placements of operating theatre imaging in England for diagnostic radiography students. Exploring preparedness, confidence and competence (technical skills development) in using C-arms within surgical environments, to highlight potential areas for future curriculum development.
Method: A cross-sectional, online survey was distributed to final year students to n=23 universities offering diagnostic radiography training in England. The survey gathered data on demographics, clinical experiences, university experiences and confidence levels in different areas of operating theatre radiography. Questions were a mix of Likert scales, multiple choice and qualitative responses. Data was analysed using descriptive statistics, and freetext responses were coded to identify common themes.
Results: There were n=84 responses from diagnostic radiography students from all n=7 regions in England. Quantitative responses included clinical placement hours in operating theatres ranged from less than 20 hours to more than 141 hours. With 84% indicating more hours would be beneficial for improving confidence levels. The qualitative data analysis identified common themes to support increased clinical hours teaching and learning in an operating theatre (35.7%) hospital environment, specifically to practice and improve technical competence with C-arm equipment (35.7%), and supplementary C-arm simulation training (83%) within university settings to improve confidence levels of C-arm positioning and locks (50%). Responses demonstrated strong confidence in understanding radiation protection (96%) and patient identification (97%) within the operating theatre to prepare for future employment. Sub themes of supervision, types of operating theatre cases, university simulation, patient interaction, identifying anatomy of images were further explored.
Conclusion: Nearly half of the responses indicated students did not feel confident in using a C-arm within the operating theatre. Students felt that simulation and spending more hours in an operating theatre during clinical placement would help improve confidence levels. The implementation of simulation-based training should be considered in universities, along with dedicating more hours to the operating theatre during clinical placements.

References

1. Hughes J. Introduction to Intra-operative and Surgical Radiography, Oxford University Press; 2018.

2. Ojodu I., Ogunsemoyin A., Hopp S., Pohlemann T., Ige O., Akinola O. C-arm fluoroscopy in orthopaedic surgical practice. European Journal of Orthopaedic Surgery & Traumatology 2018;28(8):1563–8. Doi: https://doi.org/10.1007/s00590-018-2234-7

3. Tay YX., Ng GYH., Xue M., Lim CXY., Hsiao C-W., Wei Y-M., et al. ‘Gear up and get ready’: Collaborative curriculum for radiographers supporting percutaneous nephrolithotomy in the operating theatre. Radiography 2024;30(1):178–84. Doi: https://doi.org/10.1016/j.radi.2023.11.001

4. Tay YX., Wei Y-M., Chong L. “Operating Theatre radiography not for the faint of heart”: How can we support our radiographers? J Med Imaging Radiat Sci 2022;53(2):196–202. Doi: https://doi.org/10.1016/j.jmir.2022.01.007

5. Rowe R. Increasing Technologists’ C-Arm Confidence And Competence in the Operating Room. Radiol Technol 2023;95(2).

6. Timm JR., Schnepper LL. A mixed-methods evaluation of an interprofessional clinical education model serving students, faculty, and the community. J Interprof Care 2021;35(1):92–100. Doi: https://doi.org/10.1080/13561820.2019.1710117

7. Naylor S., Foulkes D. Diagnostic radiographers working in the operating theatre: An action research project. Radiography 2018;24(1):9–14. Doi: https://doi.org/10.1016/j.radi.2017.09.001

8. Partner A., Shiner N., Hyde E., Errett S. First year student radiographers’ perceptions of a one-week simulation-based education package designed to increase clinical placement capacity. Radiography 2022;28(3):577–85. Doi: https://doi.org/10.1016/j.radi.2022.04.007

9. Weller J., Boyd M., Cumin D. Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgrad Med J 2014;90(1061):149–54. Doi: https://doi.org/10.1136/postgradmedj-2012-131168

10. Strudwick RM., Day J. Interprofessional working in diagnostic radiography. Radiography 2014;20(3):235–40. Doi: https://doi.org/10.1016/j.radi.2014.03.009

11. Health Education England. Evidence Brief: Radiography: Written evidence submitted by The Society of Radiographers (ECS0030), London; 2021.

12. Society of Radiographers. Supporting students: How to address the radiography workforce crisis. Synergy. Available from: https://www.sor.org/news/students/supporting-students-how-to-address-the-radiography [accessed June 12, 2025].

13. The Complete University Guide Limited. Results for Full time Bachelors degree,undergraduate certificates diplomas Radiography Courses in East midlands,east of england,london,north east england,north west england,south east england,south west england,west midlands,yorkshire and humber. Health and Medicine. Available from: https://www.thecompleteuniversityguide.co.uk/courses/search/undergraduate/radiography/all/east-midlands,east-of-england,london,north-east-england,north-west-england,south-east-england,south-west-england,west-midlands,yorkshire-and-humber?coursetype=full-time&qualification=bachelors-degree,undergraduate-certificates-diplomas [accessed June 10, 2025].

14. Health Care Professions Council. Number of diagnostic radiographers on the HCPC Register . Available from: https://www.hcpc-uk.org/resources/freedom-of-information-requests/2018/number-of-diagnostic-radiographers-on-the-hcpc-register---may-2018/ [accessed July 21, 2023].

15. Gibson C., Lockwood P. Impostor phenomenon traits in radiography students: Findings from a UK pilot survey. Radiography 2024;30(1):61–5. https://doi.org/10.1016/j.radi.2023.10.005

16. Naylor S., Ferris C., Burton M. Exploring the transition from student to practitioner in diagnostic radiography. Radiography 2016;22(2):131–6. Doi: https://doi.org/10.1016/j.radi.2015.09.006

17. Brewer K., Hawker C., Chambara N. Radiography student perceptions of a simulated clinical placement to enhance clinical placement capacity: A descriptive qualitative study. Radiography 2025;31(3):102939. Doi: https://doi.org/10.1016/j.radi.2025.102939

18. Arruzza E., Chau A., Gomes Y., Philpot M. Enriching surgical theatre competence through computer-based simulation. Radiography 2025;31(1):415–8. Doi: https://doi.org/10.1016/j.radi.2024.12.020

19. Yeo CH., Gordon R., Nusem I. Improving operating theatre communication between the orthopaedics surgeon and radiographer. ANZ J Surg 2014;84(5):316–9. Doi: https://doi.org/10.1111/ans.12482

Downloads

Additional Files

Published

2026-04-13

How to Cite

Pettifer, H., & Lockwood, P. (2026). A National Survey of Operating Theatre Experiences Among English Student Diagnostic Radiographers. Radiography Open, 12(1), 1–14. https://doi.org/10.7577/radopen.6446

Cited by